ARTICLE INFO

Article Type

Original Research

Authors

Azar Chavoshian   S. (1)
Moeini   B. (2*)
Bashirian   S. (2)
Feradmal   J. (3)






(1) Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
(2*) Social Departments of Health Research Center and Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
(3) Modeling of Non-communicable Disease Research Center and Department of Biostatistics and Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran

Correspondence

Article History

Received:  April  23, 2015
Accepted:  July 27, 2015
ePublished:  September 17, 2015

BRIEF TEXT


Quality of life mentions individual’s perceptions of their position in their lives according to society cultural context and individual’s targets, criteria and anxieties, and it is derived from variables such as physical health, psychological status, independency and social relation [1].

… [2-12]. Social support includes four aspects of emotional, instrumental, informational and appraisal. Social support is a protective factor against workplace tensions and acts as a trust gate against work pressure [13]. … [14-16]. Spiritual health is one of the four aspects of human health that causes public health improvement besides physical, psychical and social aspects [17] ... [18-22].

The research studied the effect of spiritual health and social support variables on quality of life among nurses.

This is an analytical descriptive research.

This study conducted among all employed female nurses (200 nurses) of Hamadan teaching hospitals specializing in women (Fatemieh) and cardiology (Ekbatan).

The two centers were randomly selected among teaching hospitals in Hamadan city and all employed female nurses in different shifts were studied according to census method. Nurses, entered the study, had a Bachelor or Master nursing degree, at least one year of clinical work, had no leadership positions and had no experience of great crisis such as death of a loved one, divorce, etc. within past six months

The research data was collected by 26-item quality of life questionnaire (WHOQOL-BREF) [23], 20-item Paloutzian and Ellison spiritual health questionnaire [24] and 24-item social support questionnaire. Quality of life Questionnaire is a short form of The World Health Organization Quality of Life that has 100 items (WHOQL-100) and it has been standardized by Nejat et al. in 2006, and has been changed into 26-item short form questionnaire [23]. The questionnaire examines the quality of life in four aspects: physical health, psychical health, social relations and living environment aspect. The participants agree or disagree to each statement by choosing a 5-point Likert scale from very good (5) to inappropriate (1). QOL measurement in each aspect was determined from zero to a hundred. Finally, QOL was classified into three levels: High QOL (75 and more), Medium QOL (50-74) and Low QOL (less than 50 grades). Reliability and validity of the questionnaire has been reported in previous studies [23]. SWBS spiritual health questionnaire designed by Ellison and Paloutzian, measures ten even items of existential health and ten odd items of religious health [24]. Spiritual health score was the sum of these two subgroups’ grades. The answer to each of the questions based on likert scale was classified as six options from entirely agree to entirely disagree. Spiritual health Minimum score was 20 and maximum score was 120. In both religious spirituality and existential health, minimum score is 10 and maximum score is 60 [24]. According to the scale instructions, spiritual health was divided into three levels of Low (20-40), Medium (40-99) and High (100-120) by the sum of each aspect’s scores. Paloutzian and Ellison reported Cronbach's alpha coefficient of religious and existential well-being and total scale as 0.91, 0.91, and 0.93 respectively [24]. Allah Bakhshian et al. also reported Cronbach’s alpha coefficient instrument after translating to Farsi as 0.82. They studied and confirmed the content validity of the questionnaire [17, 18]. Sherborne and Stewart`s sample questonnaires (MOS) [25] and the study conducted by Noori et al. [26] were used to design and build social support variables including emotional support, instrumental, informational and appraisalin which some changes was applied due to studied subject. The questionnaire contained 10 questions for emotional support, 7 questions for informational support, 5 questions for instrumental support and 2 questions for appraisalsupport. This is a self-report tool and participants determine their disagreements or agreements by a likert 5-point scale. The lowest score is 24 and highest one is 120. Participants’ high score in this scale indicates that participants have higher social support. Experts of this field evaluated content validity of the questionnaire and confirmed the content validity ratio (CVR) 0.83 and content validity index (CVI) 0.97. After collecting data of 30 nurses in one of the teaching hospitals, questionnaires’ validity was evaluated by internal consistency method and Cronbach’s alpha coefficient; that Cronbach’s alpha scale for each aspects of emotional, informational, instrumental and appraisalsupport was 0.94, 0.89, 0.72 and 0.81, respectively. Statistical analysis Data was analyzed through Pearson correlation and multiple regression tests by SPSS 18. In this study, the significance level in all tests was considered less than 0.05.

The mean age of nurses participating in the study was 33.86±6.63 years old and their work experience was 10.29±6.62 years. 77% of studied samples were married and 23% were single. 92% had Bachelor's degree and 5.9% had Master's degree. Intensive Care Unit (ICU), Cardiac Care Unit (CCU) and the women's section had the highest participants in the study as 18.7, 10.2 and 9.1% respectively. The result of current study indicated that there is a significant statistical relation between quality of life and variables such as age and work experience (P<0.05), However it was not observed in educations, marital status and work shifts variables (P>0.05). Descriptive statistics of different QOL aspects of female nurses has been represented in Table 1; generally, it was reported that 45.5% of participants had Low QOL, 49.2% Medium QOL and 5.3% had High QOL. Also, in current study, the mean score of quality of life, spiritual health and social support was obtained 51.99, 74.4 and 58.55, respectively. According to the findings, there was a direct and significant correlation between religious health and physical, psychical and environmental aspects of QOL (P<0.05). Existential health also had a direct and significant correlation between physical and psychical aspects of QOL (P<0.05). In this research there was a direct and significant correlation between emotional, informational, appraisalof social support components and different aspects of QOL (P<0.05). However, the relation between social support instrumental component and QOL aspects was insignificant (P>0.05), it was also observed between appraisalsocial support component and QOL social relations aspect (P>0.05). Results conducted from multiple regression analysis indicated that different components of social support theory overall determine 23% of variance factors related to participants’ QOL. Among examined factors, variables of emotional, informational and instrumental support had a significant share in predicting nurses’ QOL, but appraisalsupport had insignificant portion in predicting nurses’ QOL. Spiritual health components also had a significant effect on religious health, but existential health had an insignificant portion in predicting nurses’ QOL (Table 4).

… [27-30]. Keyes study indicated that emotional and instrumental support had a direct and significant relation with quality of life [31]. … [32-34]. Findings of current study and the results conducted by Asarroodi et al. also indicated that spiritual health increase significantly improves QOL in nurses [35]. … [36-38]. In the study conducted by Gashtasbi et al., the increase of age was associated with QOL decrease [39] that was different from current study findings. … [40].

Researchers offer carrying out intervention programs such as spiritual skills workshops in order to improve nurses’ QOL by using social support theory and its components.

Female nurses population and the impossibility of generalizing the results to other hospital’s staff, lack of generalization of the results to other hospitals’ nurses working in public sectors, limiting data collecting tools into just questionnaire and not using other data collection methods such as interview, etc. are the research limitations.

Social support is one of the strongest predictors of psychological well-being feeling. Overall, there was a positive and significant relation between high levels of spiritual health and different aspects of QOL and social support.

Here, researchers appreciate university’s officials, managers of Fatemiyeh and Ekbatan Educational-health centers and all nurses who have assisted us in this study.

Non-declared

The most important ethical considerations in the study were non-compulsion response to the questionnaires and individually results announcement.

This research is part of a Master’s thesis in the field of health education approved by Research Center of Social factors affected on health of Hamadan Medical Sciences University (Registration No. 9406173365) that its financial support has been done by university’s Vice Chancellor of Research and Technology.

TABLES and CHARTS

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